Homeless people are three times more likely to return to emergency departments, says new study
Media Release, Monday 6 August 2007
Homeless people are three times more likely to repeatedly return to hospital emergency departments than patients who live in stable accommodation, according to research under way at the University of Melbourne.
Researcher Gaye Moore says a lack of 24-hour welfare services and after-hours accommodation is exacerbating the problem because many homeless people visit hospitals at night and staff cannot immediately refer them to other services.
Ms Moore, a PhD candidate at the School of Nursing, has examined the admissions data from St Vincent’s Hospital emergency department in Melbourne from 2003 and 2004.
She found that:
• Homeless people accounted for 10.4 per cent of all presentations to the emergency department;
• 47.8 per cent of visits by homeless people were repeat visits, with one homeless patient returning up to 152 times in two years;
• Almost 60 per cent of emergency department visits made by homeless people were after hours when they could not be immediately referred to other services.
For her research Ms Moore studied the case histories of more than 1500 homeless patients with over 20 per cent of those living on the streets.
“People often don’t say they are homeless; people who live on the street are easy to identify but there is a big sub-group who live in boarding housings, in crisis accommodation or live in very tenuous situations in public housing,’’ Ms Moore says.
“These people are also equally vulnerable to re-presenting as those people who live on the streets.
“Homeless people have extremely complex needs; they often have drug and alcohol problems, mental illnesses, chronic diseases – or a combination of all of these issues.
“However, many of the reasons they visit the emergency department are not medical and are often difficult to address.”
As part of her PhD, Ms Moore is developing a screening program to help hospitals better identify homeless people and then refer to appropriate services.
“When health professionals try to intervene, it is often very difficult to find out the real story and get a real understanding of what’s going on in their life,’’she says.
“It requires a lot of work in building a relationship where a person can trust the health professional and maintain engagement with them.”
Ms Moore says lack of supported accommodation is a particular problem, with many homeless people coming to hospitals for shelter at night often in crisis.
“Hospital staff do not want homeless people to develop a dependency on coming to hospital, they want to intervene and be proactive in helping homeless people make changes to their lives,’’ she says.
“Staff face a big dilemma if the only option is to send them back to the street or to accommodation where they are at risk.”
St Vincent’s Hospital and community services have developed many links and special services focusing on assisting people who are homeless but Ms Moore says the battle for appropriate accommodation makes it difficult to break the cycle in homelessness.
Ms Moore’s research is funded by the Australian Research Council and St Vincent’s Hospital.
MEDIA CONTACTS
Gaye Moore
University of Melbourne
0408 366 981
Rebecca Scott
Media officer
0417 164 791
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